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General NPI Number Information
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NPI Number | 1306306626
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Entity Type | Individual
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Provider Name | NICOLAS JOSEPH AGUILA MD
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Gender | Male
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Dates
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Enumeration Date | 03/22/2019
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Last Update Date | 06/30/2023
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Provider Practice Location Address
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Address Line | 2441 OAK MYRTLE LN STE 101
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City | WESLEY CHAPEL
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State | FL
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Zip | 33544-6334
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Country | US
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Telephone | 813-465-4897
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Fax |
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Provider Business Mailing Address
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Address Line | 1320 STONY BROOK RD STE 200
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City | STONY BROOK
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State | NY
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Zip | 11790-2215
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Country | US
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Telephone | 631-444-4200
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 161329
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License Number State | FL
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